Clinical and laboratory diagnosis of monkeypox (mpox): Current status and future directions

The emergence and rapid spread of the monkeypox virus (MPXV) to non-endemic countries has brought this once obscure pathogen to the forefront of global pub-lic health. Given the range of conditions that cause similar skin lesions, and because the clinical manifestation may often be atypical in the current mpox outbreak, it can be challenging to diagnose patients based on clinical signs and symptoms. With this perspective in mind, laboratory-based diagnosis assumes a critical role for the clinical management, along with the implementation of coun-termeasures. Here, we review the clinical features reported in mpox patients, the available laboratory tests for mpox diagnosis, and discuss the principles, advances, advantages, and drawbacks of each assay. We also highlight the diag-nostic platforms with the potential to guide ongoing clinical response, particu-larly those that increase diagnostic capacity in low-and middle-income countries. With the outlook of this evolving research area, we hope to provide a resource to the community and inspire more research and the development of diagnostic al-ternatives with applications to this and future public health crises.

Automated summary

The emergence and rapid spread of the monkeypox virus (MPXV) has brought global attention to this previously obscure pathogen.The challenges in diagnosing patients based on clinical signs and symptoms, due to the similarity of skin lesions and atypical manifestations, highlight the critical role of laboratory-based diagnosis. This review discusses the clinical features of mpox patients, available laboratory tests for diagnosis, and the potential of diagnostic platforms in guiding clinical response.